Obesity in middle age may drastically raise future medicare expenditures

Overweight and obesity in young adulthood and middle age may have devastating effects on future Medicare expenditures, particularly given the continued and alarming increase in prevalence of obesity in the United States during recent decades, according to a study published in the Dec. 8 issue of The Journal of the American Medical Association.

The study, conducted by Martha L. Daviglus, M.D., professor of preventive medicine, and colleagues at Northwestern University Feinberg School of Medicine, examined the impact of body mass index (BMI) earlier in life on Medicare expenditures for treating cardiovascular-related disease, diabetes-related disease and total average annual Medicare charges, as well as cumulative Medicare charges, from age 65 to death or to age 83.

The impact of BMI in young adulthood and middle age on future Medicare expenditures from age 65 to death or to attainment of advanced age has not previously been addressed.

Medicare data from 1984 to 2002 were linked with data from the Chicago Heart Association Detection Project in Industry (which enrolled participants from 1967 to 1973) for approximately 9,980 men and about 7,620 women who were free of coronary heart disease, diabetes and major electrocardiographic abnormalities, were not underweight and were Medicare-eligible for at least two years during 1984 to 2002. Participants were classified by their baseline BMI.

The researchers found that average annual and cumulative Medicare charges were significantly higher by higher BMI for both men and women. Total average annual charges for non-overweight, overweight, obese and severely obese women were, respectively, about $6,225; $7,650, $9,610 and $12,340.

Corresponding total cumulative charges also were significantly higher – up to almost $175,000 for severely obese women. In non-overweight, overweight, obese and severely obese men, total average annual charges were, respectively, about $7,200, $8,390, $10,130 and $13,675.

Corresponding total cumulative charges were also were significantly higher – up to almost $177,000 for severely obese men. Approximately 130 million U.S. adults are overweight or obese. At the same time, the U.S. population is aging rapidly. Data from the National Center for Health Statistics indicate that the proportion of U.S. adults aged 65 and older will increase from about 12 percent currently to 20 percent by 2050.

“With current trends of increasing overweight and obesity afflicting all age groups, urgent preventive measures are required not only to lessen the burden of disease and disability associated with excess weight but also to contain future health care costs incurred by the aging population,” Daviglus said.

“Public health efforts need to include comprehensive national strategies and resources for primary prevention of weight gain from early life on, with the goal to contain and end the obesity epidemic and reduce health care costs among older persons,” Daviglus said.

Colloborating with Daviglus on this study were Kiang Liu, professor of preventive medicine; Lijing L. Yan; Amber Pirzada, M.D.; Larry Manheim; Daniel B. Garside; Renwei Wang, M.D.; Alan R. Dyer; Philip Greenland M.D., Harry W. Dingman Professor of Cardiology and chair of preventive medicine; and Jeremiah Stamler, M.D., emeritus professor of preventive medicine, Feinberg School; and Willard G. Manning, University of Chicago.